Anton Schwarz



Personal data - diagnosis

Personal data

Visible name: Anton Schwarz
Ctry: GREAT BRITAIN
State/Province: Notts
Year of birth: 1956
Age: 63
Occupation: Director
Hobbies: Skiing, Swimming
My Website:

Data at initial diagnosis

Date: 16.04.2008
Age at diagnosis: 52
PSA: 4.19
Biopsied? Yes
TUR-P? No
Gleason Score: 3 + 4 = 7a
TNM-Stages: T1c N0 M0
Remark: very low volume

Maximum measured prostate volume

Date: 08.02.2010
PSA: 4.50
Volume in ml or cm³: 43

Postoperative pathological data

Date:
Gleason Score:
pTNM-classification:
Margins:
p-L-V-P-G-Findings:
See stories of:

Prostate cancer treatments

** PSA level at the start of the treatment
from to PSA** Type Clinic City
21.02.08 4.19 Active Surveillance



Drugs

NEM = Nutritional supplement
from to Medication Quantity / unit of time
Quantity per D / M / Y etc.


PSA-History    ng/ml    logarithmic

PSA-History    ng/ml    linear

PSA doubling times in years

Doubling time is greater than previous period.
Doubling time is smaller than previous period.
* Calculated backwards for 1, 2, 4 and 8 periods.

Limit = 3 years


Calculation of doubling times in days

Doubling time in years:
Doubling time in days:
Date PSA 1* 2* 4* 8*
21.02.08 4.19
16.05.08 4.10 --
30.11.08 1.70 -- --
09.01.09 1.30 -- --
06.03.09 1.40 1.44 -- --
15.05.09 1.80 0.53 0.74 --
28.08.09 1.80 1.32 9.00
20.11.09 1.90 2.95 6.64 1.58
19.02.10 2.60 0.55 0.90 1.07 --
27.05.10 4.50 0.34 0.41 0.78 15.12
09.07.10 1.70 -- -- --
08.10.10 1.70 -- -- 4.51
12.01.11 2.00 1.12 2.19 -- 3.60
14.04.11 2.20 1.83 1.38 -- 6.61
28.07.11 2.70 0.97 1.25 1.58 3.27
01.11.11 2.10 -- -- 3.50 13.49
13.01.12 2.80 0.48 8.83 2.07 17.76
25.04.12 2.70 -- 1.33 3.50 --
02.08.12 2.80 5.17 19.37 2.87
07.11.12 2.30 -- -- 7.77 4.78
12.02.13 2.70 1.15 -- -- 4.82
13.06.13 2.80 6.32 2.10 21.62 6.23
17.09.13 2.50 -- -- -- --
18.12.13 2.50 -- 9.25 8.47
19.03.14 2.70 2.25 4.52 --
Date PSA 1* 2* 4* 8*
27.06.14 2.90 2.66 2.44 20.51 21.07
01.10.14 2.70 -- 9.35 --
07.01.15 4.80 0.32 0.73 1.12 2.04
20.02.15 2.60 -- -- -- --
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           

My Story

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Date Δ 

Last PSA from

Personal stories

       
30.06.2008 4.10 16.05.08
A routine medical assessment picked up a PSA of 4.19.

I saw my GP who was inclined to leave it. I requested referral to a specialist (luckily I have med insurance). Urologist advised biopsy. First was inconclusive in one sample of 12. Second was positive in one sample of many.Gleason 7 (3.4) Staging T1c MRI shows T2 at most M0 N0 cancer - contained in gland, peripheral signal (small/low) on RHS and unidentifiable possible signal on LHS.

Urologist very strong advice for surgery (keyhole) which is his speciality. Oncologist also advised radical prostatectomy - particularly as my mother had breast cancer and he was concerned with re-emergence in the future.
Brachytherapist states that I am suitable for all main curative options. Due to see HIFU expert in July.

My current feeling (end June 08) is towards Brachy. because of reduced side effects (in probability terms). I am aware of possible re-emergence and am researching salvage options . I am also fairly confident that the situation is improving in terms of research and resource.
       
10.10.2008 4.10 16.05.08
Had an enhanced MRI scan (end August) which shows no evidence of cancer. Am due to have prostate mapping end Oct(co-ordinate biopsy) to determine if there are any other cancerous areas. If not then I may be eligible for focal therapy as part of a trial.

Focal Therapy is currently being investigated whereby in cases where the cancer is localised it may be possible to just treat the cancerous area rather than the whole gland. This would hopefully result in fewer and less drastic side-effects.

My specialist ( Mark Emberton - UCL London) is using HIFU

My own situation is that the enhanced MRI showed no areas of cancer. All this means is that there are none large enough to register. (over 0.5cc i think) I still have the original biopsy result showing PCa cells. I have now had the prostate mapping biopsy ( template guided co-ordinate biopsy) and await results. This could show one or more small localised areas, and therefore allow consideration of focal therapy.

It could also reveal multiple foci over the gland and therefore push me down the route of whole gland treatment.
       
01.12.2008 1.70 30.11.08
The results from my prostate mapping biopsy, unfortunately, revealed that there is cancer on both sides of the gland. This means that I am not eligible for the focal therapy trial. The results confirmed that it is at very low volume and that gleason is 3+4.

Mark Emberton has suggested treating one side (HIFU) and then monitoring for a while (possibly years) before treating the other side. The thinking is that the space between treatments may allow some healing/recovery of the erectile nerves on the first side to give a better chance of erections after treating the second side.

I'm not in any rush and intend to see the Brachytherapist end of Jan for further discussions. My latest PSA is 1.7, down from 4.10. I don't know if this is good or irrelevant and await further advice.
       
01.06.2010 4.50 27.05.10
I have since had a another enhanced MRI scan in February 10, 2010 which again showed no locations of PCa (this just means that they are too small to register as we know that they are there) This was followed by a round of consultation with my two consultants (David Bottomley - Brachytherapy and Mark Emberton - Focal Therapy) both of whom agreed that a continuation of active surveillance is appropriate. I have planned another MRI in about 12 months.

One thing to watch out for if you have Medical Insurance. I have discovered that they will only cover costs for Active Surveillance (e.g. scans etc) for a limited period - in my case 5 years from date of diagnosis. They will still cover cost of actual treatment after that date but any ongoing monitoring falls on us.
       
01.07.2011 2.20 14.04.11
Still no symptoms. I had another enhanced MRI in February 2011 and for the first time a possible tumour locus was identifiable, but still small. We have agreed a further scan in September 2011 to confirm or otherwise the February scan and will report after that.
       
09.11.2011 2.10 01.11.11
I have had another Enhanced MRI which shows no definable change since February i.e. approx 5mm lesion on left peripheral zone. Gleason 3+4

PSA has dropped back to 2.1 (from 2.7), so still seems fairly stable.

In these circumstances there seems no need for further biopsy and both consultants have agreed that continuing current regime seems worthwhile. So another scan in Feb and continuing 3 monthly PSA suits me.

cheers

Anton
       
25.04.2012 2.70 25.04.12
Had another enhanced MRI in March 12.

This shows no change i.e. a confirmed tumour but very small volume on left hand side.

We feel that, as there are no symptoms and PSA remains relatively low and stable, there is still no urgency to activate treatment. I will keep monitoring PSA every 3 months and have scheduled in further scan for 12 months time.
       
28.03.2013 2.70 12.02.13
Had another enhanced MRI in Feb 13. Interestingly the area on the left which was starting to show some definition at the last scan appears to have become less distinct. This does not mean the cancer is reducing but might mean that that area was highlighting for another reason.

In these circumstances and with the PSA profile still low there seems no reason to chose treatment and we have decided to continue with Active Surveillance leading up to another scan in about a year.

cheers

Anton
       
17.03.2015 2.60 20.02.15
Repeat MRI in Feb 2014 and 2015 both show no significant change, so continuing with Active Surveillance.

The MRI is done with a 3 Tesla magnetic field

Had a spike in PSA to 4.8 in January but this was probably an anomaly as a follow up in February dropped back to 2.6.
My graph shows a fairly slow and steady growth in PSA if the occasional spikes are ignored, which is probably par with the normal increase with age.

cheers

Anton